Occupational and Environmental Medicine最新文献

{"title":"Use of pharmacotherapy for alcohol use disorders and the risk of unemployment: a cohort study of 77 503 workers in Sweden.","authors":"Devy L Elling, Melody Almroth, Kristina Berglund, Anders Hammarberg, Lluís Mangot-Sala, Heidi Taipale, Jari Tiihonen, Emelie Thern","doi":"10.1136/oemed-2025-110613","DOIUrl":"10.1136/oemed-2025-110613","url":null,"abstract":"<p><strong>Objective: </strong>Alcohol use disorders (AUDs) can lead to unemployment, yet they remain undertreated. Pharmacotherapies may strengthen labour market attachment but are underused. This study investigates the association between AUD pharmacotherapy use and the risk of becoming unemployed among individuals with an AUD diagnosis in Sweden.</p><p><strong>Methods: </strong>A longitudinal register-based study was conducted, using the Swedish Work, Illness and labour market Participation (SWIP) cohort, restricted to gainfully employed individuals between 16 and 60 years with a first-time AUD diagnosis in Sweden between 2006 and 2019 (n=77 503). The exposure was AUD pharmacotherapy use. The outcome was the first unemployment spell (≥90 consecutive days) that occurred after the first-time AUD diagnosis (2006-2020). Covariates included sociodemographic characteristics, comorbidities and unemployment history. The association between pharmacotherapy use and unemployment was examined using Cox regression models.</p><p><strong>Results: </strong>Of the cohort, 42.8% used AUD pharmacotherapy and 15 098 individuals became unemployed during the observation period (median 7.1 years, IQR 3.3-10.6 years). Relative to those with AUD who did not use any pharmacotherapy, an inverse association between the use of AUD pharmacotherapy and unemployment incidence was observed (adjusted HR (aHR): 0.86; 95% CIs 0.82 to 0.89).</p><p><strong>Conclusions: </strong>AUD pharmacotherapy may decrease the risk of long-term unemployment. The findings further underscore the importance of pharmacotherapy treatment to sustain work ability and promote a healthy workforce.</p>","PeriodicalId":19459,"journal":{"name":"Occupational and Environmental Medicine","volume":" ","pages":"23-28"},"PeriodicalIF":3.2,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13151522/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147609427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inequalities in NHS staff support among those from ethnic minority and migrant groups during the COVID-19 pandemic.","authors":"Bethany Croak, Danielle Lamb, Sharon A M Stevelink, Rupa Bhundia, Juliana Onwumere, Brendan Dempsey, Pamela Almeida-Meza, Zoe Chui, Neil Greenberg, Rosalind Raine, Charlotte Woodhead, Stephani L Hatch, Rebecca Rhead","doi":"10.1136/oemed-2025-110203","DOIUrl":"10.1136/oemed-2025-110203","url":null,"abstract":"<p><strong>Objectives: </strong>During the COVID-19 pandemic, National Health Service staff support services were implemented to promote healthcare workers' (HCWs) well-being, alongside informal support from colleagues and managers. Certain groups may be less likely to access support, including HCWs from ethnic minority and migrant groups. These HCWs are more likely to experience discrimination and abuse at work, which may also erode access to positive and protective resources. Therefore, this study examined variation in formal support programme use and perceptions of support from managers and colleagues by ethnicity and migration status.</p><p><strong>Methods: </strong>This study analysed survey data from 9769 HCWs in England who completed the baseline survey (launched April 2020) and the 6-month follow-up using descriptive statistics and binary logistic regression.</p><p><strong>Results: </strong>At 6 months, 51% of participants met the threshold for probable common mental disorder. HCWs from White Other (Adjusted Odds Ratio (AOR) 0.79; 95% CI 0.64 to 0.99) and Asian ethnic groups (AOR 0.65; 95% CI 0.57 to 0.74) were less likely to feel supported by their colleagues than White British HCWs. Similarly, those born outside of the UK and European Union were less likely to feel supported by their colleagues than UK-born HCWs (AOR 0.70; 95% CI 0.52 to 0.94). No variations in support programme use or manager support were found across ethnicity or migration status.</p><p><strong>Conclusions: </strong>The study suggests equitable formal support but identified critical disparities in perceived support from colleagues for HCWs during the COVID-19 pandemic. Improving workplace well-being should address the underlying social and structural factors that influence peer support and belonging.</p>","PeriodicalId":19459,"journal":{"name":"Occupational and Environmental Medicine","volume":" ","pages":"29-35"},"PeriodicalIF":3.2,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13151436/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147633899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum and urinary indium as early biomarkers of airway dysfunction in indium-exposed workers.","authors":"Ting-An Yang, Jhe-Ping Lin, Hao-Yi Fan, Chia-Cheng Chang, Jau-Yuan Chen, Yu-Chung Tsao","doi":"10.1136/oemed-2025-110642","DOIUrl":"10.1136/oemed-2025-110642","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the relationships between indium exposure biomarkers and pulmonary injury markers among indium-exposed workers, and to evaluate the exploratory diagnostic utility of indium levels for identifying subclinical ventilatory abnormalities.</p><p><strong>Methods: </strong>This cross-sectional study recruited 30 workers from a Taiwanese indium-tin oxide (ITO) facility. Participants completed standardised questionnaires, spirometry, diffusing capacity (diffusing capacity of the lungs for carbon monoxide) testing and chest radiography. Serum indium (In-S) and urinary indium (In-U) concentrations were quantified alongside pulmonary biomarkers (Krebs von den Lungen-6 (KL-6), Surfactant Protein A (SP-A), Surfactant Protein D (SP-D)) and systemic inflammatory and oxidative stress markers (Lactate Dehydrogenase (LDH), Malondialdehyde, C-Reactive Protein, 8-hydroxy-2-deoxyguanosine). Group comparisons were stratified by In-S level and workstation. Associations were assessed using Spearman's correlation. Receiver operating characteristic (ROC) analyses were performed to explore the diagnostic performance of indium biomarkers.</p><p><strong>Results: </strong>Production workers had significantly higher In-S and In-U levels than administrative staff (p<0.001). KL-6 and LDH were elevated in the high In-S group (p<0.01). In-S and In-U correlated moderately with KL-6 (ρ=0.556 and 0.536, respectively; p<0.001), and with SP-D (ρ=0.388 and 0.384; p=0.013 and 0.014). In-U showed negative correlation with SP-A (ρ=-0.329, p=0.038) and positive correlation with LDH (ρ=0.317, p=0.046). ROC analysis demonstrated exploratory diagnostic performance within this cohort of In-S for identifying reduced maximal mid-expiratory flow and reduced FEV₁/FVC ratio.</p><p><strong>Conclusions: </strong>In-S and In-U levels are associated with biological markers of alveolar epithelial injury and functional parameters related to airway physiology. These findings support the potential role of indium biomonitoring in occupational surveillance, while underscoring the need for cautious interpretation given the cross-sectional design and limited sample size.</p>","PeriodicalId":19459,"journal":{"name":"Occupational and Environmental Medicine","volume":" ","pages":"36-41"},"PeriodicalIF":3.2,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147486877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Occupational exposure to chlorinated solvents and lung cancer: results of the SYNERGY case-control study.","authors":"Wenxin Wan, Roel Vermeulen, Lützen Portengen, Ann Olsson, Joachim Schüz, Wendy Bijoux, Wolfgang Ahrens, Christine Barul, Thomas Behrens, Thomas Brüning, Neil E Caporaso, Dario Consonni, Paul A Demers, Eleonora Fabianova, Guillermo Fernández-Tardón, John Field, Francesco Forastiere, Lenka Foretova, Calvin B Ge, Per Gustavsson, Vladimir Janout, Karl-Heinz Jöckel, Stefan Karrasch, Benjamin Kendzia, Maria Teresa Landi, Jolanta Lissowska, Dana Mates, John McLaughlin, Franco Merletti, Enrica Migliore, Tamás Pándics, Hermann Pohlabeln, Loredana Radoï, Lorenzo Richiardi, Miriam Schejbalova, Jack Siemiatycki, Beata Świątkowska, Heinz-Erich Wichmann, David Zaridze, Kurt Straif, Hans Kromhout, Susan Peters","doi":"10.1136/oemed-2025-110129","DOIUrl":"10.1136/oemed-2025-110129","url":null,"abstract":"<p><strong>Objective: </strong>The association between occupational exposure to chlorinated solvents and lung cancer remains inconclusive. This study investigated this relationship using data from the internationally pooled SYNERGY study.</p><p><strong>Methods: </strong>Data from 14 case-control studies conducted in 13 European countries and Canada were pooled, including 28 048 participants (12 329 cases and 15 719 controls). Lifetime occupational exposure to chlorinated solvents was assessed using the ALOHA+job-exposure matrix. ORs and 95% CIs were estimated using unconditional logistic regression, adjusted for study centre, age, sex, smoking (pack-years and cessation), cumulative exposure to five occupational lung carcinogens (asbestos, hexavalent chromium, polycyclic aromatic hydrocarbons, respirable crystalline silica and diesel engine exhaust), cumulative benzene exposure and employment in high-risk occupations ('List A' jobs). Associations were estimated across categories of exposure levels, durations and analyses stratified by smoking status and lung cancer subtypes.</p><p><strong>Results: </strong>We found no evidence of an association between ever exposure to chlorinated solvents and lung cancer risk (OR 1.03; 95% CI 0.96 to 1.10). Among exposed individuals, a positive trend with cumulative exposure was observed (p=0.031), but not when non-exposed individuals were included (p=0.173). Positive trends were found with exposure duration (p=0.005 for exposed; p=0.048 overall); risks were modestly elevated (OR 1.11) in those exposed for 20 or more years. No increased risk was observed across smoking strata or lung cancer subtypes.</p><p><strong>Conclusions: </strong>This pooled analysis provides limited evidence of an association between occupational exposure to chlorinated solvents and lung cancer, though exposure-response trends were noted among exposed individuals.</p>","PeriodicalId":19459,"journal":{"name":"Occupational and Environmental Medicine","volume":" ","pages":"54-57"},"PeriodicalIF":3.2,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13271013/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147444609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rotating night shift work, gestational diabetes and risk of type 2 diabetes among US nurses.","authors":"Isha Agarwal, Cara Frankenfeld, Eva Schernhammer, Susanne Strohmaier, Abby F Fleisch, Janet Rich-Edwards, Deirdre K Tobias","doi":"10.1136/oemed-2025-110594","DOIUrl":"10.1136/oemed-2025-110594","url":null,"abstract":"<p><strong>Objectives: </strong>We sought to evaluate whether rotating night shift work increases the risk of type 2 diabetes, particularly among women with a history of gestational diabetes mellitus (GDM).</p><p><strong>Methods: </strong>We included 50 122 Nurses' Health Study II participants who were parous at baseline in 1989 or at any time during follow-up through 2019. Using multivariable-adjusted Cox proportional hazards models, we estimated the HRs and 95% CIs for the associations between cumulative years of rotating night shift work and incident type 2 diabetes, overall, and by history of GDM.</p><p><strong>Results: </strong>Compared with participants who never engaged in rotating night shift work, we observed a graded increase in the risk of type 2 diabetes with cumulative years of rotating night shift work: HR (95% CI) 1.14 (1.04 to 1.24) for <5 years, 1.32 (1.17 to 1.49) for 5-10 years and 1.32 (1.16 to 1.50) for >10 years (p-linear trend <0.001). Stratifying by history of GDM, we observed a similar pattern of associations among participants without a history of GDM, but not among those with a history of GDM (p-interaction=0.02). History of GDM was strongly associated with risk of incident type 2 diabetes in all women, including those who never worked rotating night shifts: HR (95% CI) 4.76 (3.90 to 5.81).</p><p><strong>Conclusions/interpretation: </strong>Cumulative years of rotating night shift work were modestly associated with a higher risk of type 2 diabetes, overall, and among nurses without a history of GDM. Rotating night shift work was not associated with risk of type 2 diabetes among individuals with a history of GDM, an exceptionally high-risk subgroup for type 2 diabetes.</p>","PeriodicalId":19459,"journal":{"name":"Occupational and Environmental Medicine","volume":" ","pages":"16-22"},"PeriodicalIF":3.2,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13055994/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147444648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of crosswalk methodologies for a diesel engine exhaust job-exposure matrix and impacts on lung cancer risk estimates in workers in Ontario, Canada.","authors":"Stephanie Ziembicki, Tracy L Kirkham, Victoria H Arrandale, Tanya Navaneelan, Paul A Demers","doi":"10.1136/oemed-2025-110471","DOIUrl":"10.1136/oemed-2025-110471","url":null,"abstract":"<p><strong>Objective: </strong>This study investigates the effect of three crosswalk methods of the Diesel Exhaust in Canada Job-Exposure Matrix (DEC-JEM) on lung cancer risk among Ontario workers.</p><p><strong>Methods: </strong>Ontario workers (2 364 427 identified through workers' compensation claims (1983-2019)) were followed for cancer diagnoses through linkage with the Ontario Cancer Registry (1964-2019). DEC-JEM is coded in North American Industry Classification System 2002 and National Occupation Classification-Statistics 2006 as an industry-occupation intersection structure, while the cohort is coded in Standard Industry Classification (SIC) 1970 and Canadian Classification and Dictionary of Occupations (CCDO). Three different methods were used to crosswalk. Cox-proportional hazards models of lung cancer were used to estimate HRs and 95% CIs, adjusted for age, birth year and sex. Results were validated against the CANadian Job-Exposure Matrix (CANJEM), coded directly into SIC1970-CCDO intersections.</p><p><strong>Results: </strong>DEC-JEM₂ and DEC-JEM₃ had similar case counts and exposure distributions for each exposure level and threshold, notably lower than DEC-JEM₁. Increased lung cancer risk was observed using all methods. Differences in risk between methods were most noticeable at higher exposure levels, while little difference was observed among low exposed groups. DEC-JEM₃ had the highest risk. Risks mostly differed between DEC-JEM and CANJEM, particularly higher exposure levels (high, very high).</p><p><strong>Conclusions: </strong>Crosswalk decisions can change a JEM's exposure distribution, determine which cases get classified as exposed and influence disease risk estimates. Future crosswalks should consider unexposed matches and a weighted average exposure for one-to-multiple matches. This study's crosswalk methods provide opportunities to save resources while improving exposure assessment.</p>","PeriodicalId":19459,"journal":{"name":"Occupational and Environmental Medicine","volume":" ","pages":"42-49"},"PeriodicalIF":3.2,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146106336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cancer and all-cause mortality among United States union poultry workers.","authors":"M Alexander Ball, Benjamin C Amick, Wendy N Nembhard, Christina C Joshua, Leanna M Delhey, Samuel L Schach, Jaimi L Allen","doi":"10.1136/oemed-2025-110495","DOIUrl":"10.1136/oemed-2025-110495","url":null,"abstract":"<p><strong>Objectives: </strong>Several industry-specific hazards are present in the poultry working environment. It is not well known whether risk factors unique to poultry working increase all-cause and cancer mortality relative to other industry types. The study objective was to compare all-cause and cancer mortality among poultry workers to non-poultry food workers.</p><p><strong>Methods: </strong>Occupational data for 30 411 poultry and 16 405 non-poultry workers were obtained from United Food and Commercial Workers union records and matched to the National Death Index up to 31 December 2019 to conduct a retrospective cohort study. Unadjusted and adjusted hazard ratios (aHR) and their 95% CIs from time-stratified Cox proportional hazard regression models were run to compare all-cause and cancer mortality among poultry and non-poultry workers.</p><p><strong>Results: </strong>Across the full cohort, no statistically significant elevation in all-cause or cancer mortality among poultry workers was observed (all-cause: aHR 0.98, 95% CI 0.95 to 1.01; cancer: aHR 1.05, 95% CI 0.97 to 1.13); however, time-period sensitivity was evident. After accounting for calendar time, poultry workers hired before 1960 had a 62% greater cancer mortality hazard compared with non-poultry workers (aHR 1.62, 95% CI 1.25 to 2.11). Poultry workers hired between 1980 and 1989 had a 59% (aHR 1.59, 95% CI 1.40 to 1.79) and 86% (aHR 1.86, 95% CI 1.39 to 2.48) greater all-cause and cancer mortality risk, respectively.</p><p><strong>Conclusions: </strong>Union poultry workers hired in the United States during the 20th century faced greater all-cause and cancer mortality compared with non-poultry workers; however, this elevation was period-sensitive, varying by employment start date.</p>","PeriodicalId":19459,"journal":{"name":"Occupational and Environmental Medicine","volume":" ","pages":"10-15"},"PeriodicalIF":3.2,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13151466/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147434531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mortality of workers exposed to tetrafluoroethylene (TFE) and perfluorooctanoic acid (PFOA) in a plant producing fluoropolymers in Italy, 1960-2024.","authors":"Dario Consonni, Silvia Fustinoni, Daan Joris Aarts","doi":"10.1136/oemed-2025-110490","DOIUrl":"10.1136/oemed-2025-110490","url":null,"abstract":"<p><strong>Objective: </strong>Within a multicentre cohort study, mortality (1960-2008) had been evaluated of workers exposed to tetrafluoroethylene (TFE) and perfluorooctanoic acid (PFOA) employed (1960-1999) in a plant producing fluoropolymers in Piedmont, North-West Italy. Follow-up of this cohort was updated through 2024.</p><p><strong>Methods: </strong>Workers' job histories were merged with a semiquantitative job-exposure matrix to calculate cumulative exposure to TFE (still used) and PFOA (phased out in 2013). We calculated standardised mortality ratios (SMRs) and 95% CIs.</p><p><strong>Results: </strong>Among 505 male workers, there was high correlation between cumulative exposure to TFE and PFOA (Spearman's rho 0.57). SMRs (reference: regional rates) were elevated for lung cancer (SMR 1.43, 95% CI 0.95 to 2.16, 23 deaths) and non-Hodgkin's lymphoma (NHL, SMR 2.73, 95% CI 1.23 to 6.07, 6 deaths). Pleural cancer was also in excess (SMR 3.18 using national rates, 95% CI 1.02 to 9.84, 3 deaths). Mortality from leukaemia (three deaths) was not elevated. Lung cancer was not associated with length of employment or exposure. Three workers who died from liver, kidney and testis cancer had been exposed to TFE and unexposed to PFOA. NHL was positively associated with length of employment, time since first employment and exposure to TFE (all 6 deaths exposed, SMR 3.38, 95% CI 1.52 to 7.51 in unlagged analysis, excess confirmed in lagged analyses), while 3 were unexposed to PFOA. The NHL excess occurred among workers aged 65+ years last employed before 2000.</p><p><strong>Conclusions: </strong>This study found elevated mortality from NHL. The available evidence suggests an association with TFE rather than PFOA exposure, although exposure misclassification cannot be ruled out.</p>","PeriodicalId":19459,"journal":{"name":"Occupational and Environmental Medicine","volume":" ","pages":"50-53"},"PeriodicalIF":3.2,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13151503/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147308344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using job exposure matrices to estimate an individual's exposure for compensation?","authors":"Hans Kromhout, Dick J J Heederik","doi":"10.1136/oemed-2025-110290","DOIUrl":"10.1136/oemed-2025-110290","url":null,"abstract":"<p><strong>Introduction: </strong>Job-exposure matrices (JEMs) are being used to assign (quantitative levels of) exposure to individuals based on their job history. In human observational studies, a group-based approach in which every individual with a similar job will be assigned similar exposure will not bias exposure-response associations but will result in loss of precision. However, since JEMs do not consider between-worker differences in average exposure, some individual workers' cumulative exposures will be underestimated. This may affect their chances of compensation when a minimal (cumulative) exposure threshold is applied.</p><p><strong>Methods: </strong>We analysed more than 80 000 repeated exposure measurements from a variety of industries and consequently combined variance components of location and worker (within a location within a job) to estimate the bandwidth of individual average exposures within a job. This allowed estimating percentiles one and two standard deviations (SD) above the median of workers' exposure distribution within a job (across locations/companies).</p><p><strong>Results: </strong>The bandwidth factor appeared to be larger for exposures to particulates than for gases. It was also larger for biological agents. For exposure to particulate matter, the bandwidth factor varied slightly between industries (₈₄BW_factor range 1-4) with a median 2.5.</p><p><strong>Conclusion: </strong>By applying a default bandwidth factor to an average exposure estimate resulting from a quantitative JEM, the Dutch occupational disease compensation scheme has chosen for an approach that recognises between-worker differences in exposure. This approach, in addition to considering uncertainty in exposure-response associations, addresses another important factor of uncertainty in ascertaining occupational disease based on the 'presumably plausible' principle.</p>","PeriodicalId":19459,"journal":{"name":"Occupational and Environmental Medicine","volume":" ","pages":"58-60"},"PeriodicalIF":3.2,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13151424/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146207134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Silicosis prevalence and associated occupational risk factors among cassiterite (tin ore) miners in eastern Rwanda: a cross-sectional analysis of mining practice and risk in an active mining cohort.","authors":"Samuel Ambrose Hatfield, Symaque Dusabeyezu, Alphonse Nshimyiryo, Anne Niyigena, Peter Barebwanuwe, Michael Miller, Robert Tumusime, Jean Nepomuscene Renzaho, Michel Niyonsenga, Leah Traube, Tarek Elkady, Daniel Mays, Wellars Dusingizimana, Stella Savarimuthu, Paul Sonenthal, Phoebe Mwiseneza, Joel M Mubiligi, Fredrick Kateera, Kamali Innocent, Vincent K Cubaka","doi":"10.1136/oemed-2024-110031","DOIUrl":"10.1136/oemed-2024-110031","url":null,"abstract":"<p><strong>Objectives: </strong>Silicosis is one of the most common forms of pneumoconiosis worldwide. In Rwanda, there is a lack of data on the silicosis burden and occupational risk among underground miners.</p><p><strong>Methods: </strong>We conducted a cross-sectional study among all miners from eight cassiterite (tin ore) mining sites in Kayonza district, eastern Rwanda. Questionnaire data and chest radiography were collected at Rwinkwavu District Hospital. Two radiologists reviewed all the chest radiographs using International Labour Organization (ILO) criteria, with a third radiologist reviewing films with ILO rating discrepancies. Logistic regression was performed to investigate risk factors associated with radiographic silicosis.</p><p><strong>Results: </strong>In total, 1021 mine workers were included in the primary outcome (risk) analysis. The median age was 32 years (IQR 26-40), and 948 participants (93%) were male. Of all participants, 94 (9%) were diagnosed with silicosis in the primary analysis. Increased odds of silicosis were associated with working in a blasting station (adjusted OR (aOR) 3.30; 95% CI 1.68 to 6.45), excavation station (aOR 2.77; 95% CI 1.09 to 7.04), drilling station (aOR 2.51; 95% CI 1.34 to 4.70), exposure to tobacco (aOR 1.92; 95% CI 1.14 to 3.24) and increased time of working in mining (aOR 1.05 per year spent in mining; 95% CI 1.01 to 1.09).</p><p><strong>Conclusions: </strong>High-risk mining tasks, tobacco use and duration of mining employment were significantly associated with increased risk of having a silicosis diagnosis. Our results indicate that screening and preliminary occupational risk analysis in a rural mining cohort is technically feasible.</p>","PeriodicalId":19459,"journal":{"name":"Occupational and Environmental Medicine","volume":" ","pages":"1-9"},"PeriodicalIF":3.2,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147347738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}